DEPARTMENT OF INSURANCE

Affiliations

Name	Gaines, Mark Titus	DOIID	568049	NAIC NPN	7662214

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Resident	Agent	Health	2/6/2004	7/31/2026
Active	Resident	Agent	Life	1/30/2004	7/31/2026
Active	Resident	Agent	Property	6/6/2003	7/31/2026
Active	Resident	Agent	Casualty	6/27/2003	7/31/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Modern Home Insurance Company	300791	Agent - Casualty	1/26/2023
Active	American Modern Home Insurance Company	300791	Agent - Property	1/26/2023
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	4/9/2020
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Property	4/9/2020
Inactive	Assurity Life Insurance Company	301099	Agent - Health	11/21/2006	1/23/2009
Inactive	Assurity Life Insurance Company	301099	Agent - Life	11/21/2006	1/23/2009
Active	Bristol West Insurance Company	301655	Agent - Casualty	7/17/2012
Active	Bristol West Insurance Company	301655	Agent - Property	7/17/2012
Active	Dairyland Insurance Company	301370	Agent - Casualty	3/5/2004
Active	FB Insurance Company (The)	301763	Agent - Casualty	6/27/2003
Active	FB Insurance Company (The)	301763	Agent - Property	6/6/2003
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	2/25/2004
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	2/25/2004
Inactive	John Hancock Life Insurance Company	300821	Agent - Health	12/2/2005	12/30/2009
Inactive	John Hancock Life Insurance Company	300821	Agent - Life	12/2/2005	12/30/2009
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	9/19/2008	6/8/2011
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	9/19/2008	6/8/2011
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Casualty	6/27/2003
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Property	6/6/2003
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Health	4/7/2004
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Life	4/7/2004
Inactive	Victoria Fire & Casualty Company	300313	Agent - Casualty	5/2/2011	6/23/2017
Inactive	Victoria Fire & Casualty Company	300313	Agent - Property	5/2/2011	6/23/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Dental Choice Agency Inc.	398085	Agent - Health	7/22/2004	11/8/2013
Active	Designated Agent Company Inc.	681257	Agent - Health	8/4/2014
Active	Designated Agent Company Inc.	681257	Agent - Life	8/4/2014
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Casualty	3/26/2004
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Property	3/26/2004
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Health	4/7/2004
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Life	8/4/2014